Tele-consultations and electronic medical records driven remote patient care: Responding to the COVID-19 lockdown in India

Abstract

Purpose: To describe the experience of tele-consultations addressed at the centre of excellence of a multi-tier ophthalmology hospital network in India during the ongoing novel coronavirus (COVID-19) lockdown. Methods: This cross-sectional hospital-based study included 7,008 tele-consultations presenting between March 23 rd and April 19 th 2020. A three-level protocol was implemented to triage the calls. The data of patient queries were collected using a Google Form/Sheets and the tele-calls were returned using the patient information retrieved from the electronic medical record system. Results: Overall, 7,008 tele-calls were addressed, of which 2,805 (40.02%) patients where a clinical-related query was answered were included for analysis. The most common queries were related to redness/pain/watering/blurring of vision (31.52%), closely followed by usage of medications (31.05%). The majority of the queries were directed to the department of cornea (34.15%), followed by retina (24.74%). Less than one-fifth of the patients were from the lower socio-economic class (16.08%) and one-fourth were new patients (23.96%). The most common advice given to the patient was related to management of medications (54.15%) followed by appointment related (17.79%). Emergency requests requiring further evaluation by an ophthalmologist accounted for a small percentage (16.36%) of patients. Conclusion: Tracking of tele-consultations and access to patient information from the electronic medical records enabled a timely response in an ongoing lockdown due to the COVID-19 pandemic. The current experience provided valuable insights to the possibility of managing patient follow-up visits remotely in the future.

Impact of COVID-19-related lockdown-I on a network of rural eye centres in Southern India

“…It would be useful to encourage teleconsultations and take care of postoperative patients through teleconsultation in the future. [ 7 11 ]…”

“…Teleconsultation services were offered as described in our previous publication. [ 7 ] Data on the lockdown-I period were compared with the pre-lockdown period.…”

Prescription digitization, online preservation, and retrieval on a smartphone

“…In the current COVID-19 pandemic, many primary care physicians have started teleconsultations despite several limitations. [ 22 23 ] They can use these free services for storing patients' data for any future legal needs.…”

Pivoting to teleconsultation for paediatric ophthalmology and strabismus: Our experience during COVID-19 times

“…Further details of flow of teleconsultation can be found in the article by Das and associates. [ 6 ] The prescription of medicines adhered to the telemedicine practice guidelines of India[ 7 ] and the previous medications advice given during the last visit of the follow-up patients was asked to be continued where relevant. The medical report with the ophthalmologist advice was sent to the patient via short message, email or WhatsApp at the completion of the call in PDF format on an official letter head which was electronically signed by the consulting ophthalmologist.…”